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Specialty Choices Among Medical Students and Interns in Egyptian Accredited and Non Accredited Faculties of Medicine

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Specialty Choices Among Medical Students and Interns in Egyptian Accredited and Non Accredited Faculties of Medicine 12 Current Science International 1(1): 12-19, 2011 ISSN: 2077-4435 Specialty Choices Among Medical Students And Interns In Egyptian Accredited And Non Accredited Faculties Of Medicine. Omnia S. El Seifi and Eman M. Mortada Department of Community, Environmental and Occupational Medicine, Faculty of Medicine – Zagazig University, Egypt. ABSTRACT Background: Worldwide, the process of specialty choices and how the graduates of medical schools select their areas of specialization is a growing concern. Objectives: 1) detect and compare specialty preference among Zagazig (non accredited) and Suez Canal (accredited) Universities' medical students and interns 2) study important factors that are considered when choosing the specialties and 3)determine if there is difference in choosing specialties according to gender and accreditation. Methods: A cross-sectional study was conducted from January 2011 to May 2011 in Zagazig and Suez Canal faculties of medicine. Using multistage sampling technique, a sample from interns, 4th, 5th and 6th year medical students was included in the study. The sample size was (640) out of 2800 in Zagazig faculty of medicine and (374) out of 681 in Suez Canal faculty of medicine. Results: General Surgery have the 1st rank among other specialties in Zagazig faculty of medicine (17.5%) while Obstetrics & gynecology was the 1st choice in Suez Canal Faculty of Medicine (18.0%) with no significant difference between them except for Family medicine specialty which was significantly higher in Suez Canal Faculty of Medicine. Male choices were higher than females with significant differences in the following specialties; General Surgery, Ophthalmology, and Anesthesiology in both universities in addition to Radiology in Suez Canal University. There were no significant difference in most of factors underlying specialty choice between the two faculties except for career opportunities in the Zagazig faculty of medicine and role model in the specialty in Suez Canal faculty of medicine . Regarding gender difference, there were significant differences in nearly all factors in both groups except for family expectations in Zagazig University and role model of specialty in Suez Canal University. Conclusions: Our study revealed similarities and differences in specialty preferences and factors influencing these choices among male and female students in both faculties. The main factors affecting specialty choices were students' interest in the career and social aspects and responsibilities with unclear role of accreditation in choosing specialty. Key words: Specialty choices, medical students and health officers, accreditation. Introduction Medical school graduates are an important source of a country’s physicians. Choosing their medical specialty is one of the most important decisions they will face in their medical career, as from one hand; their choices decide the manpower distribution among different medical specialties all over the country, and from the other hand finding a specialty that suits the strengths, weaknesses, lifestyle, intellectual challenge, and research potential—among other factors—that agree with each one of them is not an easy process. Determining how the graduates of these schools select their areas of specialization is essential to achieving a balanced distribution of doctors among all specialties (Pei et al., 2006). Worldwide, the process of specialty choices and the distribution of physician specialization is a growing concern, as these choices may not meet community needs and lead to shortage of physicians in some specialties which may be a problem in certain countries (Brotherton et al ., 2004). It was often believed that selcting a speciality is only a process of personal choice. While in fact there are other important fators influncing it such as; economic factors, social expectation, training opportunnities, educational experiances and controllable life style which play important roles in the decision of the students and interns in choosing their specialities. (Anzllotti et al., 2001). Recent studies show that gender of medical students or interns plays an important role in choosing the type of speciality as it was found that Lifestyle, role models, and expectations associated with gender shape their career plans (Salter, 2007; Fukuda and Harada, 2010). Educational accreditation is a type of quality assurance process under which services and operations of educational institutions or programs are evaluated by an external body to determine if applicable standards are met. If standards are met, accredited status is granted by the agency (Global Standards for Excellence in Education, 2011). Accreditation of medical faculties ensures quality medical education leads to quality health care. National Authority for Quality Assurance & Accreditation of Education –Egypt (NAQAAE) is the accrediting body for all Egyptian educational institutions in Egypt since year 2007, aiming to support Egyptian Corresponding Author: Omnia Elseifi, Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Egypt. E-mail: [email protected]. 13 Curr. Sci. Int. 1(1): 12-19, 2011 educational institutes by fostering their quality assurance practices specially those related to student centered education and career guidance (NAQAAE, 2011). Faculty of Medicine, Suez Canal University (FOM-SCU) was established as the first community- oriented/based, problem-based and student-centered medical school in Egypt, this system has been shown to develop better psychosocial skills in students and a better attitude toward patients than students trained in more traditional ways (Caminal et al., 2004). Also the faculty adopting the quality standards and principals and was accredited since (15/5/2010) to be one of the first faculties of medicine which is accreted in Egypt. As there is a continuous seeking of our medical faculties (including faculty of medicine, Zagazig University) for accreditation in addition to scarcity of national data and researches about specialty choices and factors underlying them. The objectives of our study were to: 1) detect and compare specialty preference among Zagazig and Suez Canal Universities' medical students and interns, 2) study important factors that are considered when choosing the specialties and 3) determine if there is difference in chosen specialty according to gender and accreditation. Subjects and methods: Study design and setting: A cross-sectional study was conducted from January 2011 to May 2011 in two faculties of medicine in Zagazig and Suez Canal Universities. Study sample and procedure: Using multistage sampling technique, a random sample from interns, 4th, 5th and 6th year medical students was included in the study. The sample size was (640) out of 2800 in faculty of medicine Zagazig University and (374) out of 681 in faculty of medicine Suez Canal University. Two class rooms (seminars) from each grade in each faculty (regarding medical students) and two shifts in two randomly chosen clinical specialties (General surgery and pediatrics for interns) were randomly selected then the selected classes and shifts were included as cluster where all available students & interns were interviewed. We include three different grades of medical students beside interns due to expected to year to- year fluctuations in the number and percent of medical students choosing different specialties, and attitude change that may occur with time. Students from 1st, 2nd and 3rd grades were excluded from the study because they are to some degree away from exposure to clinical experience in the early years of medical studies and they may haven’t formulated a complete picture about clinical specialties. Tools of the study: The data were collected after verbal consent from participants through a self administrated questionnaire including data about: age, sex, grade, preferred specialty (the first choice only), lastly they are asked about factors that were considered when choosing their specialty choices as; Family expectations; what the family encourage and expect the student to be in the future. Career opportunity; the future opportunity of the career for promotion. Ability to establish their own practice; the level of difficulties to establish one’s own practice, including the practice cost, malpractice costs and practice risk. Role model in the specialty; referring to the behavior of supervisors, or residents that leads to good impression. Work related hazards; the incidence of exposure to infections, such as infectious hepatitis, or other infectious diseases. Training period; length of training required and working hours. High and stable future income; financial rewards relative to other specialties. Prestige of specialty; in relation to other medical specialties. Related life style; personal free time for leisure, family and control of total weekly hours spent on professional responsibilities. Type and number of patients served and the strength of specialty in job market. These factors were based on similar published studies (Dorsey et al., 2005 ; Pei et al., 2006; Scott et al., 2008 and Fukuda and Harada, 2010). Answer was either by (Yes or No) and only those who choose the answer “Yes” were presented in tables. The questionnaire was pre-tested on 30 students from different grades to determine the response and applicability of it and changes were made accordingly. Ethical aspect and administrative approach: necessary official permission was taken out from
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